Guideline to reduce vaccination distress offers menu of options

A new guideline, published in the Canadian Medical Association Journal, aims to reduce distress experienced by patients during vaccinations. The 2026 clinical practice guideline update builds upon the 2015 Help Eliminate Pain in Kids & Adults (HELPinKids&Adults) Collaborative recommendations, providing evidence-based strategies to improve the vaccination experience. Common negative effects of vaccines include fear and pain, which are prevalent among both adults and children, particularly since the COVID-19 pandemic.

Dr. Anna Taddio, a senior author and researcher at the University of Toronto and The Hospital for Sick Children, emphasizes that these strategies are not routinely incorporated into vaccination programs or practices. The updated guideline presents a 5P framework, consisting of process, procedural, physical, pharmacologic, and psychological interventions, to help clinicians, organizations, and individuals minimize distress during vaccinations.

The guideline suggests utilizing an evidence-based tool called the CARD system, which stands for Comfort, Ask, Relax, and Distract. This tool, developed by several authors, offers practical strategies for individuals and caregivers to select coping mechanisms before or during the vaccination process. These options include education, rapid injections, feeding or sweet solutions for infants, topical anesthetics, and age-appropriate distractions, among others.

The guideline encourages patients and their caregivers to choose the most effective coping strategy for their specific needs. By implementing these individualized interventions, the goal is to make vaccination a more positive experience, reduce fear, and ultimately increase confidence in vaccines.